Willingness Test

Willingness Test

This test is designed to help you identify first, what kind of problems you may be having and second, what you are willing to do about it. This test does not cover the full variety of problems people can have, just the ones that are most likely repairable through a process of recovery. Please note that this test is NOT making suggestions or giving advice, it is strictly a means to identify your willingness.
What kinds of problems are you having?
Describe your romantic issues - (if any)
What are you willing and able to do about it?
Describe your work relationship issues - (if any)
What are you willing and able to do about it?
Describe your friends, family or other relationship issues - (if any)
What are you willing and able to do about it?
Describe your mental health issues - (if any)
What are you willing and able to do about it?
Describe your addictions - (if any)
What are you willing and able to do about it?
Describe your physical health issues - (if any)
What are you willing and able to do about it?
Describe your self-esteem issues - (if any)
What are you willing and able to do about it?
Describe your financial issues - (if any)
What are you willing and able to do about it?
Describe your past traumas - (if any)
What are you willing and able to do about it?
Describe your sleep related issues - (if any)
What are you willing and able to do about it?
Describe your anger, depression and or anxiety - (if any)
What are you willing and able to do about it?
Describe your other issues, problems or concerns - (if any)
Describe what are you willing to do about your other issues, problems or concerns
Who are you willing to speak with? (if other, please add their name and email address)

Other
Name

First NameLast Name
Email
example@example.com
By submitting I hereby confirm that the information I have given above is true, and that I will be receiving an email response to my submission and an invitation to discuss the results with a nonprofessional member of Mixed Recovery.
Signature
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